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PubMed2002

Exposure of garbage truck drivers and maintenance personnel at a waste handling centre to polycyclic aromatic hydrocarbons derived from diesel exhaust.

Exposure to diesel exhaust was evaluated in summer and winter by measuring vapour and particle phase polycyclic aromatic hydrocarbons (PAHs). Fifteen PAHs were simultaneously determined from the air samples obtained from truck drivers collecting household waste and maintenance personnel at a waste handling centre. The major compounds analysed from the personal air samples of exposed workers were naphthalene, phenanthrene and fluorene. The total PAH exposure (sum of 15 PAHs) of garbage truck drivers ranged from 71 to 2,660 ng m(-3) and from 68 to 900 ng m-3 in the maintenance work. The exposure of garbage truck drivers to benzo[a]pyrene (B[a]P) ranged from the mean of 0.03 to 0.3 ng m(-3) whereas no B[a]P in control samples or in those collected from maintenance workers was detected. A statistically significant difference in diesel-derived PAH exposure between the garbage truck drivers and the control group in both seasons (in summer p = 0.0022, degrees of freedom (df) 70.5; and in winter p < 0.0001, df = 80.4) was observed. Also, a significant difference in PAH exposure between the garbage truck drivers and the maintenance workers (in summer p < 0.0001, df = 50.1; and in winter p < 0.0001, df = 44.2) was obtained.

Adult↗
PubMed2003

Retention and postinsertion maintenance of bar-clip, ball and magnet attachments in mandibular implant overdenture treatment: an in vivo comparison after 3 months of function.

It could be hypothesised that attachments, which provide more retention against vertical and horizontal dislodgement, will be associated with more favourable parameters of oral function. This in vivo study is designed to provide data regarding initial retention force, loss of retention force after 3 months of function and postinsertion maintenance and complications associated with the use of magnet, bar-clip and ball attachments in mandibular overdenture treatment. Eighteen edentulous subjects received two permucosal implants in the inter-foramina region of the mandible, a new denture and three successive suprastructure modalities (magnet-, bar-clip and ball attachments). The retention force of the attachments at baseline and after 3 months was measured in a standardised way. The amount and type of postinsertion maintenance that was related to the attachment were evaluated. No differences in retention force at baseline and after 3 months of loading were observed for all three attachment types. The mean retention forces of magnet attachments, bar-clip attachments and ball attachments were 8.1, 31.3 and 29.7 N respectively. Functional maintenance complications related to the attachments were predominantly observed in 11/36 magnet attachments. Functional problems in the ball attachment group were relatively rare, easily manageable and seen in 4/36 attachments. The bar-clip attachments exhibited no maintenance problems at all.

Adult↗
PubMed1999

Tuberculosis chemoprophylaxis using a liquid isoniazid-methadone admixture for drug users in methadone maintenance.

BACKGROUND: Tuberculosis is common in drug users, although compliance with therapy may be difficult in this population. OBJECTIVE: To evaluate an approach to enhancing compliance with tuberculosis chemoprophylaxis in drug users enrolled on methadone maintenance utilizing an isoniazid (INH)-methadone admixture. DESIGN: A prospective cohort study. SETTING: A drug treatment program in New Haven, Connecticut, USA. PATIENTS: Opioid-dependent drug users enrolled in methadone maintenance. INTERVENTION: Liquid isoniazid was mixed into subjects' daily dose of methadone. Vitamin B6 was given to subjects for self-administration. MEASUREMENTS AND MAIN RESULTS: Number of eligible subjects, reasons for not starting therapy, number starting therapy, proportion completing therapy and median duration of INH therapy were calculated. Thirty-nine subjects were eligible for INH chemoprophylaxis: 34 (87%) received INH mixed directly in their methadone and five (13%) had their INH consumption supervised by a nurse. Among these subjects, 72% (28/39) completed therapy. Among the 11 subjects who discontinued INH, discharge from the methadone maintenance program was the most common reason--73% (8/11). Thus, among the 31 subjects who were not discharged from methadone maintenance, 90% (28/31) successfully completed INH prophylaxis. The median duration of therapy was 182 days. CONCLUSIONS: Tuberculosis chemoprophylaxis using a liquid isoniazid-methadone admixture appears to be an effective approach to enhancing compliance with this therapy in methadone-maintained drug users.

Antitubercular Agents↗
PubMed1998

A comparison of omeprazole, lansoprazole and pantoprazole in the maintenance treatment of severe reflux oesophagitis.

BACKGROUND: Proton pump inhibitors are effective for the healing of oesophagitis. Standard doses of omeprazole, lansoprazole or pantoprazole are sufficient for healing in mild to moderate cases of oesophagitis. AIM: To compare the efficacy of double the standard doses of omeprazole, lansoprazole or pantoprazole for maintenance treatment of severe oesophagitis complicated by a stricture. METHODS: Thirty-six patients with reflux oesophagitis and stricture confirmed by endoscopy were included in a prospective study comparing three maintenance therapies. In all cases weekly dilatation of the stenosis was performed and patients were treated with omeprazole 20 mg b.d. until healing of oesophagitis and dysphagia relief were achieved. Thirty participants responded to therapy and were then randomly assigned to 4 weeks of maintenance treatment with omeprazole (20 mg b.d.; n = 10), lansoprazole (30 mg b.d.; n = 10) or pantoprazole (40 mg b.d.; n = 10). Subsequently, endoscopies were performed-the endoscopists were blinded to the therapy assignment. The endpoints were defined as the absence of oesophagitis, oesophageal stricture and complaints. RESULTS: After 4 weeks of treatment, the number of patients remaining in remission (no oesophagitis or stricture and no symptoms) was nine out of 10 (90%) in the omeprazole group, two out of 10 (20%) in the lansoprazole group (P < 0.01) and three out of 10 (30%) in the pantoprazole group (P < 0.01). CONCLUSIONS: In our study omeprazole was superior to either lansoprazole or pantoprazole in the maintenance treatment of complicated gastro-oesophageal reflux disease.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed1999

Triple therapy for Helicobacter pylori eradication is more effective than long-term maintenance antisecretory treatment in the prevention of recurrence of duodenal ulcer: a prospective long-term follow-up study.

BACKGROUND: The effectiveness of Helicobacter pylori eradication treatment and long term acid suppression maintenance in the natural course of duodenal ulcer has not been directly compared. AIM: To compare in a prospective randomized study the effectiveness of H. pylori eradication on the prevention of recurrence of duodenal ulcer with long-term maintenance acid suppression therapy. METHODS: One hundred and fourteen duodenal ulcer patients were randomized to the treatment over a 12-month period. Fifty-seven of them received triple therapy consisting of 1 g sucralfate q.d.s. for 28 days, 300 mg metronidazole q.d.s. for 14 days and 250 mg clarithromycin q.d.s. for 14 days. Another 57 received 20 mg omeprazole q.d.s. for 12 months. An upper endoscopy was performed before treatment, at 6 weeks, and 2, 6 and 12 months after the first endoscopy. Side-effects were self-recorded and clinical follow-ups were arranged for up to 4.25 years. RESULTS: The ulcer healing rate was 90.2% (95% confidence interval (95% CI): 79-97%) in the omeprazole group at 6 weeks as compared to 83.3% (95% CI: 70-93%) in the triple therapy group (P = 0.38). There was a higher success rate of pain control in the omeprazole group. Side-effects were more frequently reported and compliance was poorer in the triple therapy group during the first 4 weeks. During follow-up, more relapses were seen in the omeprazole group (9.8%, 95% CI: 3-21%) than the triple therapy group (4.2%, 95% CI: 1-13%) at 1 year (P = 0.44). All relapses were due to the persistence of H. pylori infection. At the 1 year follow-up, none of the patients who were H. pylori negative had an endoscopic relapse compared to 7 out of 56 patients who remained H. pylori positive (12.5%, 95% CI: 5-24%, P = 0.018). After a mean follow-up of 4.07 years, none of those who remained H. pylori negative had an ulcer relapse while the 11 out of 41 who remained H. pylori positive had an ulcer relapse (26.8%, 95% CI 14-43, P = 0. 0005). CONCLUSIONS: Both regimens were highly effective in healing ulcers. The eradication of H. pylori infection was associated with more side-effects and poor compliance but was more effective than the maintenance therapy in reducing the recurrence of duodenal ulcers. For the prevention of ulcer recurrence, testing of H. pylori status after triple therapy is more important than maintenance therapy.

Adult↗
PubMed1999

Sevoflurane versus propofol for induction and maintenance of anaesthesia with the laryngeal mask airway in children.

We compared patient outcomes for propofol vs sevoflurane with the laryngeal mask airway (LMA) using either spontaneous breathing (SB) or pressure controlled ventilation (PCV). One hundred and twenty children undergoing minor surgery below the umbilicus were randomly assigned to receive either (1) propofol 3 mg.kg-1 followed by a maintenance infusion of 5 mg.kg-1.h-1, or (2) induction with sevoflurane 7% followed by maintenance with 1.7%. Following LMA insertion, patients were given atracurium and underwent PCV if surgery was expected to last > or = 30 min. The following assessments were made: time to LMA insertion/removal, airway problems, cardiorespiratory effects and recovery characteristics. The first time insertion success rates were similar, but insertion time was shorter with sevoflurane (115 +/- 67 s vs 252 +/- 107 s, P < 0.0001). One patient coughed during placement, but there were no other problems during any phase of anaesthesia in any group. Heart rate was higher in the sevoflurane group following insertion, during maintenance and emergence (all P < 0.03). There were no differences in blood pressure and oxygen saturation among groups PECO2 in the SB group was unaffected by the agent used. Emergence was more rapid (232 +/- 104 s vs 348 +/- 127 s, P < 0.0001) and postoperative agitation more common (15% vs 0%, P = 0.02) with sevoflurane. There were no differences in the Aldrete scores among groups. Patient outcome was similar for the SB and PCV groups. We concluded that the techniques described here using propofol and sevoflurane are equally suitable for induction and maintenance of anaesthesia with the LMA in children undergoing minor surgery below the umbilicus. Emergence is more rapid, but postoperative agitation more common with sevoflurane.

Anesthetics, Inhalation↗
PubMed2000

Lessons from obesity management programmes: greater initial weight loss improves long-term maintenance.

It is a common belief that weight loss achieved at a slow rate is better preserved than if the weight is lost more rapidly. However, the literature shows that initial weight loss is positively, not negatively, related to long-term weight maintenance. There is evidence from randomised intervention trials to support that a greater initial weight loss induced without changes in lifestyle (e.g. liquid formula diets or anorectic drugs) improves long-term weight maintenance, providing it is followed by a 1-2 years integrated weight maintenance programme consisting of lifestyle interventions involving dietary change, nutritional education, behaviour therapy and increased physical activity. In conclusion, we find evidence to suggest that a greater initial weight loss as the first step of a weight management programme may result in improved sustained weight maintenance.

Appetite Depressants↗
PubMedDate not supplied

Blood preservation 33. Phosphate enhancement of ribose maintenance of 2,3-DPG and ATP.

Blood storage in CPD-adenine supplemented with 25 mM inosine and 10 mM phosphate gave 2,3-DPG levels as high as 140 per cent of normal for six weeks of blood storage at 4 C. Lower but normal 2,3-DPG levels were maintained throughout six weeks with inosine or inosine plus ribose. Ribose alone provided marginally increased DPG maintenance over the control, but ribose with phosphate maintained 2,3-DPG levels above 70 per cent of normal for five weeks of storage and two weeks longer than the control preservative. ATP levels were maintained at normal or above for six weeks with phosphate plus ribose or inosine. 2,3-DPG maintenance has previously been shown to be impaired by phosphate, unless inosine is also present. The ribose and inosine effects on 2,3-DPG maintenance are not additive. Phosphate also has an enhancement effect on ATP maintenance in the presence of either ribose or inosine.

Adenine↗
PubMed2006

Optimum use of biologics and role of maintenance therapy in colon cancer.

The current standard of care for the treatment of metastatic colorectal cancer involves at least six different regimens, and with the advent of new therapies, including biologic therapies, patients are projected to live beyond an average of 2 years. Data suggest a synergy between the biologics, which are in their infancy in terms of utilization, and they are being tested in the adjuvant setting in stage II and stage III disease. Ongoing and future trials will determine how best to incorporate these medicines into combination chemotherapy and determine if these medicines (or others) will have a role in maintenance chemotherapy for patients with metastatic colon cancer. However, the concept of incorporating maintenance therapy for colon cancer is clearly not established. Maintenance therapy has a requirement for less toxicity than current front-line therapies, and over the coming years, new agents will become available that maintain response and improve quality of life. Clinical trials involving novel agents as maintenance therapy are needed.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2003

Body composition analysis by bioelectrical impedance in chronic maintenance dialysis patients: comparisons to the National Health and Nutrition Examination Survey III.

OBJECTIVE: To compare bioelectrical impedance analysis derived parameters in chronic maintenance dialysis patients to those obtained in National Health and Nutrition Examination Survey (NHANES) III. DESIGN: Cross-sectional nutritional surveillance study. SETTING: Hospital-based, not-for-profit chronic maintenance dialysis center. PATIENTS: A total of 913 chronic maintenance dialysis patients and a subset of 10,263 subjects from NHANES III who underwent bioelectrical impedance analysis. Independent (Predictor) Variables: Bioelectrical impedance parameters including resistance, reactance, phase angle, and total body capacitance. MAIN OUTCOME MEASURES: Total body water, intracellular and extracellular water, body cell mass, fat free mass, fat mass. RESULTS: Relative to NHANES III, end-stage renal disease patients have lower resistance (3%), reactance (26%), phase angle (28%); and intracellular water (9%) values, whereas extracellular water content is 17% higher (P < .001). In addition, body cell mass, fat free mass, and fat mass were lower in end-stage renal disease patients when compared with NHANES III subjects (9%, 3%, and 12%, respectively; P < .001). CONCLUSIONS: End-stage renal disease patients have a lower tissue mass than the general population and remain in a state of overhydration while on chronic maintenance dialysis therapy.

Adolescent↗
PubMed2004

Effects of a new maintenance fluid containing sodium acetate as the base component and electrolytes during renal biopsies in patients with chronic glomerulonephritis.

A new maintenance fluid containing sodium acetate as the base component and electrolytes (Veen 3G, test preparation) for a maximum of 24 h was infused to 15 patients hospitalized for renal biopsies and requiring intravenous supplements of water, electrolytes and energy because oral or enteric ingestion was inadequate or impossible. A physical examination, blood chemistry tests and urinalysis were performed, and the global improvement rating was obtained by scoring the effects on a) maintenance of cardiovascular hemodynamics (systolic blood pressure), b) blood glucose control (blood glucose level), c) utilization of sugar (free fatty acids, total ketone bodies), d) maintenance of serum electrolytes, e) amount of sugar excreted in the urine and f) maintenance of urinary volume. The results were excellent or good in all of the 15 patients analyzed. The test agent was not the direct cause of any adverse events or abnormal changes in laboratory findings, and no safety-related problems were observed in any of the patients. These results indicated that the test preparation used in this study is a clinically useful and highly safe fluid agent.

Adult↗
PubMed1991

A placebo-controlled trial of maintenance therapy with fluconazole after treatment of cryptococcal meningitis in the acquired immunodeficiency syndrome. California Collaborative Treatment Group.

BACKGROUND AND METHODS: In patients with the acquired immunodeficiency syndrome (AIDS), the rate of relapse after primary treatment for cryptococcal meningitis remains high. We conducted a controlled, double-blind trial to evaluate the efficacy of maintenance therapy with fluconazole. At entry into the study, all participants had sterile cultures of cerebrospinal fluid, blood, and urine after following a standardized course of therapy for culture-proved cryptococcal meningitis. The patients were randomly assigned to take either fluconazole or placebo as maintenance therapy. The dose of fluconazole was 100 mg daily in the first phase of study and 200 mg daily in the second phase. RESULTS: Of 84 patients initially enrolled, 16 (19 percent) were found to have silent, persistent infection on the basis of cultures that became positive after entry into the study; 7 other patients were lost to follow-up shortly after entry. Of the remaining 61 patients, 10 of 27 assigned to placebo (37 percent) and 1 of 34 assigned to fluconazole (3 percent) had a recurrence of cryptococcal infection at any site (difference in risk, 34 percent; 95 percent confidence interval, 15 to 53). Of the 11 recurrent infections, 7 were detected in urine obtained after prostatic massage. There were four recurrent meningeal infections in the patients taking placebo, but none in those taking fluconazole (mean duration of follow-up, 164 days) (P = 0.03). In multivariate analyses, the best predictors of recurrence-free survival were fluconazole treatment (P = 0.02; relative hazard, 13.2), a lower serum cryptococcal-antigen titer (P = 0.05; relative hazard, 1.2), and more prolonged primary therapy with flucytosine (P = 0.09; relative hazard, 1.1). Survival and toxicity were similar in the two maintenance-treatment groups. CONCLUSIONS: In patients with AIDS, silent persistent infection is common after clinically successful treatment for cryptococcal meningitis. Maintenance therapy with fluconazole is highly effective in preventing recurrent cryptococcal infection.

Acquired Immunodeficiency Syndrome↗
PubMed2006

Maintenance treatment of major depression in old age.

BACKGROUND: Elderly patients with major depression, including those having a first episode, are at high risk for recurrence of depression, disability, and death. METHODS: We tested the efficacy of maintenance paroxetine and monthly interpersonal psychotherapy in patients 70 years of age or older who had depression (55 percent of whom were having a first episode) in a 2-by-2, randomized, double-blind, placebo-controlled trial. Among patients with a response to treatment with paroxetine and psychotherapy, 116 were randomly assigned to one of four maintenance-treatment programs (either paroxetine or placebo combined with either monthly psychotherapy or clinical-management sessions) for two years or until the recurrence of major depression. Clinical-management sessions, conducted by the same nurses, social workers, and psychologists who provided psychotherapy, involved discussion of symptoms. RESULTS: Major depression recurred within two years in 35 percent of the patients receiving paroxetine and psychotherapy, 37 percent of those receiving paroxetine and clinical-management sessions, 68 percent of those receiving placebo and psychotherapy, and 58 percent of those receiving placebo and clinical-management sessions (P=0.02). After adjustment for the effect of psychotherapy, the relative risk of recurrence among those receiving placebo was 2.4 times (95 percent confidence interval, 1.4 to 4.2) that among those receiving paroxetine. The number of patients needed to be treated with paroxetine to prevent one recurrence was 4 (95 percent confidence interval, 2.3 to 10.9). Patients with fewer and less severe coexisting medical conditions (such as hypertension or cardiac disease) received greater benefit from paroxetine (P=0.03 for the interaction between treatment with paroxetine and baseline severity of medical illness). CONCLUSIONS: Patients 70 years of age or older with major depression who had a response to initial treatment with paroxetine and psychotherapy were less likely to have recurrent depression if they received two years of maintenance therapy with paroxetine. Monthly maintenance psychotherapy did not prevent recurrent depression. (ClinicalTrials.gov number, NCT00178100.).

Aged↗
PubMed2005

Reconstitution of papillomavirus E2-mediated plasmid maintenance in Saccharomyces cerevisiae by the Brd4 bromodomain protein.

The papillomavirus E2 protein functions in viral transcriptional regulation, DNA replication, and episomal genome maintenance. Viral genomes are maintained in dividing cells by attachment to mitotic chromosomes by means of the E2 protein. To investigate the chromosomal tethering function of E2, plasmid stability assays were developed in Saccharomyces cerevisiae to determine whether the E2 protein could maintain plasmids containing the yeast autonomous replication sequence replication element but with the centromeric element replaced by E2-binding sites. E2 expression was not sufficient to maintain such plasmids, but plasmid stability could be rescued by expression of the mammalian protein Brd4. In the presence of both Brd4 and E2 proteins, plasmids with multiple E2-binding sites were stable without selection. S. cerevisiae encodes a homolog of Brd4 named Bdf1 that does not contain the C-terminal domain that interacts with the E2 protein. A fusion protein of Bdf1 and the Brd4 C-terminal "tail" could support E2-mediated plasmid maintenance in yeast. Using a panel of mutated E2 proteins, we determined that plasmid stability required the ability of E2 to bind DNA and to interact with Brd4 and mammalian mitotic chromosomes but did not require its replication initiation and transactivation functions. The S. cerevisiae-based plasmid maintenance assays described here are invaluable tools for dissecting mechanisms of episomal viral genome replication and screening for additional host protein factors involved in plasmid maintenance.

Binding Sites↗
PubMed1999

Discontinuation of maintenance therapy for CMV retinitis in AIDS patients on highly active antiretroviral therapy.

The use of highly active antiretroviral therapy (HAART) has dramatically modified the natural history of cytomegalovirus retinitis (CMVR) in AIDS patients. In this context, we discontinued maintenance therapy in eight AIDS patients with previous CMVR and a good and persistent immune and virological response to HAART (CD(4) >/= 75/mm(3) in all patients, viral load </=30,000 copies of RNA/ml in seven patients and negative CMV viremia in six patients whose viremia was evaluated). The median recurrence-free interval before maintenance discontinuation was 613 days (326-787). No recurrence was observed after a median follow-up of 248 days (183-368) without maintenance therapy. In conclusion, discontinuation of maintenance therapy for CMVR in AIDS patients with good immune response to HAART can be considered and appears to be safe with a careful follow-up.

Acquired Immunodeficiency Syndrome↗
PubMed2004

Effects of green tea on weight maintenance after body-weight loss.

The present study was conducted to investigate whether green tea may improve weight maintenance by preventing or limiting weight regain after weight loss of 5 to 10 % in overweight and moderately obese subjects. The study had a randomised, parallel, placebo-controlled design. A total of 104 overweight and moderately obese male and female subjects (age 18-60 years; BMI 25-35 kg/m(2)) participated. The study consisted of a very-low-energy diet intervention (VLED; 2.1 MJ/d) of 4 weeks followed by a weight-maintenance period of 13 weeks in which the subjects received green tea or placebo. The green tea contained caffeine (104 mg/d) and catechins (573 mg/d, of which 323 mg was epigallocatechin gallate). Subjects lost 6.4 (sd 1.9) kg or 7.5 (sd 2.2) % of their original body weight during the VLED (P<0.001). Body-weight regain was not significantly different between the green tea and the placebo group (30.5 (sd 61.8) % and 19.7 (sd 56.9) %, respectively). In the green tea treatment, habitual high caffeine consumption was associated with a higher weight regain compared with habitual low caffeine consumption (39 (sd 17) and 16 (sd 11) %, respectively; P<0.05). We conclude that weight maintenance after 7.5 % body-weight loss was not affected by green tea treatment and that habitual caffeine consumption affected weight maintenance in the green tea treatment.

Adolescent↗
PubMed2006

Maintenance threonine requirement and efficiency of its use for accretion of whole-body threonine and protein in Atlantic salmon (Salmo salar L.) fry.

Eighteen groups of seventy Atlantic salmon (Salmo salar L.) fry (initial mean body weight 0.8 (sd 0.01) g) were fed on semi-purified diets containing graded levels of l-threonine (Thr) in 15 litres aquaria at a temperature of 14.5+/-1 degrees C. Doses of Thr represented 1, 31, 41, 51, 62, 72, 83 and 93 % of its ideal level for optimum protein deposition. Indispensable amino acids other than Thr were included in the same proportion (on a g/16 g N basis) as in the Atlantic salmon fry whole-body carcass. Following 36 d of feeding and a 36 h fast, fry were killed for whole-body protein and amino acid analysis. Weight gain (r2 0.98), protein accretion (r2 0.97), and Thr accretion (r2 0.97) were linear (P<0.01) functions of Thr intake. Slope of the Thr accretion regression line showed that the efficiency of Thr utilisation above maintenance was 76 %. At zero Thr intake, fry lost 5.4 mg Thr/kg body weight0.75 per d. The Thr maintenance requirement was 7.2 mg/kg body weight0.75 per d and the Thr requirement for growth was 66 mg for 1 g protein deposition. Increasing doses of Thr resulted in increased (P<0.05) concentrations of histidine and lysine, and decreased concentrations of isoleucine in whole-body protein. The maintenance need for Thr represented 13.4 % of the total need for Thr. The data suggest that efficiency of Thr utilisation above maintenance is constant at all levels of Thr intake between 1 and 93 % of the level required for optimum protein deposition.

Amino Acids↗
PubMed2006

Nutrient-stimulated glucagon-like peptide 1 release after body-weight loss and weight maintenance in human subjects.

Glucagon-like peptide 1 (GLP-1) is a peptide hormone that is released in response to nutrient ingestion. Postprandial GLP-1 release has been reported to be attenuated in obese subjects, but reports on the effect of weight loss on GLP-1 are conflicting. The aim of the present study was to clarify the effect of a weight-loss period and a consecutive weight-maintenance period on nutrient-stimulated GLP-1 release in obese subjects. Nutrient-stimulated (standard breakfast; 1.9 MJ) GLP-1 release was investigated in thirty-two obese subjects on three occasions: before weight loss (T1) (BMI 30.0 (sd 2.5) kg/m(2)); after a 6-week very-low-energy diet (VLED) (T2) (BMI 27.6 (sd 2.3) kg/m(2)); after a 3-month weight-maintenance period (T3) (BMI 27.9 (sd 2.3) kg/m(2)). At each occasion, following a fasting blood sample the test meal was fed and blood was drawn every 30 min for 2 h relative to ingestion in order to determine plasma GLP-1, insulin, glucose and NEFA concentrations. Subjects lost 7 (sd 3.4) kg during the VLED (P<0.0001) and regained 1 (sd 3.2) kg during the weight-maintenance period (NS). The area under the curve for nutrient-stimulated plasma GLP-1 (pmol/l x h) was significantly decreased (P=0.01) at T2 (6.8 (sd 1)) compared with T1 (12.8 (sd 2.9)) and T3 (11.1 (sd 1.5)). Since we found a rebound of concentrations after a weight-maintenance period, decrease after weight loss seems to be transient and possibly due to a negative energy balance.

Adipose Tissue↗